Reoperation for coronary artery disease. 10 years of clinical follow-up.

From a 15-year follow-up study of 743 patients who underwent initial operation for coronary artery disease, 64 patients required reoperation for recurrence of angina and were followed-up for 15 years or less (mean, 6.2 years). Patients undergoing reoperation tended to be older but not significantly so (50.9 +/- 8.3 years vs. 57.5 +/- 9.7 years), had more left main coronary artery disease (p less than 0.001), and had more triple-vessel disease (p less than 0.001) than those undergoing the initial operation. There were no significant differences in sex, prior myocardial infarctions, or prevalence of abnormal ventriculograms between the two groups. The cumulative survival rate during a 10-year follow-up period after reoperation did not differ from the rate after the initial operations. There was less relief of angina in the first year after reoperation than after initial operation, but thereafter, the annual increases in recurrence of angina were similar. Although there were more myocardial infarctions after reoperation in the first 6 postoperative years, the cumulative incidence after 10 years did not differ between the two groups. We conclude that reoperation yields a similar survival benefit but produces less early relief of angina than initial operation.